|
HC PET MYOCARD PERFUSION SINGLE STUDY REST/STRESS CONCUR CT
|
Facility
|
IP
|
$2,671.00
|
|
|
Service Code
|
CPT 78430
|
| Hospital Charge Code |
40400014
|
|
Hospital Revenue Code
|
404
|
| Min. Negotiated Rate |
$1,859.02 |
| Max. Negotiated Rate |
$2,403.90 |
| Rate for Payer: Aetna Commercial |
$2,270.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,205.98
|
| Rate for Payer: BCN Commercial |
$2,205.98
|
| Rate for Payer: Cash Price |
$2,136.80
|
| Rate for Payer: Cofinity Commercial |
$2,297.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,136.80
|
| Rate for Payer: Healthscope Commercial |
$2,403.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,003.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,270.35
|
| Rate for Payer: Nomi Health Commercial |
$2,190.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,003.25
|
| Rate for Payer: PHP Commercial |
$2,270.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,323.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,859.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,350.48
|
| Rate for Payer: UHC Core |
$2,230.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,003.25
|
|
|
HC PET MYOCARD PERFUSION SINGLE STUDY REST/STRESS CONCUR CT
|
Facility
|
OP
|
$2,671.00
|
|
|
Service Code
|
CPT 78430
|
| Hospital Charge Code |
40400014
|
|
Hospital Revenue Code
|
404
|
| Min. Negotiated Rate |
$470.90 |
| Max. Negotiated Rate |
$2,403.90 |
| Rate for Payer: Aetna Commercial |
$2,270.35
|
| Rate for Payer: Aetna Medicare |
$694.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$834.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$834.69
|
| Rate for Payer: BCBS Complete |
$494.40
|
| Rate for Payer: BCBS MAPPO |
$667.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,195.83
|
| Rate for Payer: BCN Commercial |
$2,195.83
|
| Rate for Payer: BCN Medicare Advantage |
$667.75
|
| Rate for Payer: Cash Price |
$2,136.80
|
| Rate for Payer: Cofinity Commercial |
$2,297.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,136.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$667.75
|
| Rate for Payer: Healthscope Commercial |
$2,403.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,003.25
|
| Rate for Payer: Mclaren Medicaid |
$470.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$701.14
|
| Rate for Payer: Meridian Medicaid |
$494.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$767.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$734.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,270.35
|
| Rate for Payer: Nomi Health Commercial |
$2,190.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,003.25
|
| Rate for Payer: PACE Senior Care Partners |
$634.36
|
| Rate for Payer: PACE SWMI |
$667.75
|
| Rate for Payer: PHP Commercial |
$2,270.35
|
| Rate for Payer: PHP Medicare Advantage |
$667.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,323.77
|
| Rate for Payer: Priority Health Medicare |
$674.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,859.02
|
| Rate for Payer: Railroad Medicare Medicare |
$667.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,350.48
|
| Rate for Payer: UHC Core |
$2,230.28
|
| Rate for Payer: UHC Exchange |
$667.75
|
| Rate for Payer: UHC Medicaid |
$470.90
|
| Rate for Payer: UHC Medicare Advantage |
$667.75
|
| Rate for Payer: UHCCP Medicaid |
$470.90
|
| Rate for Payer: VA VA |
$667.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,003.25
|
|
|
HC PET SKULL-MIDTHIGH
|
Facility
|
IP
|
$4,960.63
|
|
|
Service Code
|
CPT 78812
|
| Hospital Charge Code |
40400009
|
|
Hospital Revenue Code
|
404
|
| Min. Negotiated Rate |
$3,452.60 |
| Max. Negotiated Rate |
$4,464.57 |
| Rate for Payer: Aetna Commercial |
$4,216.54
|
| Rate for Payer: BCBS Trust/PPO |
$4,096.98
|
| Rate for Payer: BCN Commercial |
$4,096.98
|
| Rate for Payer: Cash Price |
$3,968.50
|
| Rate for Payer: Cofinity Commercial |
$4,266.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,968.50
|
| Rate for Payer: Healthscope Commercial |
$4,464.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,720.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,216.54
|
| Rate for Payer: Nomi Health Commercial |
$4,067.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,720.47
|
| Rate for Payer: PHP Commercial |
$4,216.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,315.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,452.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,365.35
|
| Rate for Payer: UHC Core |
$4,142.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,720.47
|
|
|
HC PET SKULL-MIDTHIGH
|
Facility
|
OP
|
$4,960.63
|
|
|
Service Code
|
CPT 78812
|
| Hospital Charge Code |
40400009
|
|
Hospital Revenue Code
|
404
|
| Min. Negotiated Rate |
$874.56 |
| Max. Negotiated Rate |
$4,464.57 |
| Rate for Payer: Aetna Commercial |
$4,216.54
|
| Rate for Payer: Aetna Medicare |
$1,289.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,550.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,550.20
|
| Rate for Payer: BCBS Complete |
$918.21
|
| Rate for Payer: BCBS MAPPO |
$1,240.16
|
| Rate for Payer: BCBS Trust/PPO |
$4,078.13
|
| Rate for Payer: BCN Commercial |
$4,078.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,240.16
|
| Rate for Payer: Cash Price |
$3,968.50
|
| Rate for Payer: Cofinity Commercial |
$4,266.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,968.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,240.16
|
| Rate for Payer: Healthscope Commercial |
$4,464.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,720.47
|
| Rate for Payer: Mclaren Medicaid |
$874.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,302.17
|
| Rate for Payer: Meridian Medicaid |
$918.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,426.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,364.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,216.54
|
| Rate for Payer: Nomi Health Commercial |
$4,067.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,720.47
|
| Rate for Payer: PACE Senior Care Partners |
$1,178.15
|
| Rate for Payer: PACE SWMI |
$1,240.16
|
| Rate for Payer: PHP Commercial |
$4,216.54
|
| Rate for Payer: PHP Medicare Advantage |
$1,240.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$874.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,315.75
|
| Rate for Payer: Priority Health Medicare |
$1,252.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,452.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,240.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,365.35
|
| Rate for Payer: UHC Core |
$4,142.13
|
| Rate for Payer: UHC Exchange |
$1,240.16
|
| Rate for Payer: UHC Medicaid |
$874.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,240.16
|
| Rate for Payer: UHCCP Medicaid |
$874.56
|
| Rate for Payer: VA VA |
$1,240.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,720.47
|
|
|
HC PET TUMOR SKULL TO THIGH
|
Facility
|
OP
|
$4,414.62
|
|
|
Service Code
|
CPT 78815
|
| Hospital Charge Code |
40400004
|
|
Hospital Revenue Code
|
404
|
| Min. Negotiated Rate |
$778.30 |
| Max. Negotiated Rate |
$3,973.16 |
| Rate for Payer: Aetna Commercial |
$3,752.43
|
| Rate for Payer: Aetna Medicare |
$1,147.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,379.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,379.57
|
| Rate for Payer: BCBS Complete |
$817.15
|
| Rate for Payer: BCBS MAPPO |
$1,103.65
|
| Rate for Payer: BCBS Trust/PPO |
$3,629.26
|
| Rate for Payer: BCN Commercial |
$3,629.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,103.65
|
| Rate for Payer: Cash Price |
$3,531.70
|
| Rate for Payer: Cofinity Commercial |
$3,796.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,531.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,103.65
|
| Rate for Payer: Healthscope Commercial |
$3,973.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,310.97
|
| Rate for Payer: Mclaren Medicaid |
$778.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,158.84
|
| Rate for Payer: Meridian Medicaid |
$817.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,269.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,214.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,752.43
|
| Rate for Payer: Nomi Health Commercial |
$3,619.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,310.97
|
| Rate for Payer: PACE Senior Care Partners |
$1,048.47
|
| Rate for Payer: PACE SWMI |
$1,103.65
|
| Rate for Payer: PHP Commercial |
$3,752.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,103.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$778.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,840.72
|
| Rate for Payer: Priority Health Medicare |
$1,114.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,072.58
|
| Rate for Payer: Railroad Medicare Medicare |
$1,103.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,884.87
|
| Rate for Payer: UHC Core |
$3,686.21
|
| Rate for Payer: UHC Exchange |
$1,103.65
|
| Rate for Payer: UHC Medicaid |
$778.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,103.65
|
| Rate for Payer: UHCCP Medicaid |
$778.30
|
| Rate for Payer: VA VA |
$1,103.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,310.97
|
|
|
HC PET TUMOR SKULL TO THIGH
|
Facility
|
IP
|
$4,414.62
|
|
|
Service Code
|
CPT 78815
|
| Hospital Charge Code |
40400004
|
|
Hospital Revenue Code
|
404
|
| Min. Negotiated Rate |
$3,072.58 |
| Max. Negotiated Rate |
$3,973.16 |
| Rate for Payer: Aetna Commercial |
$3,752.43
|
| Rate for Payer: BCBS Trust/PPO |
$3,646.03
|
| Rate for Payer: BCN Commercial |
$3,646.03
|
| Rate for Payer: Cash Price |
$3,531.70
|
| Rate for Payer: Cofinity Commercial |
$3,796.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,531.70
|
| Rate for Payer: Healthscope Commercial |
$3,973.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,310.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,752.43
|
| Rate for Payer: Nomi Health Commercial |
$3,619.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,310.97
|
| Rate for Payer: PHP Commercial |
$3,752.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,840.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,072.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,884.87
|
| Rate for Payer: UHC Core |
$3,686.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,310.97
|
|
|
HC PET WHOLE BODY
|
Facility
|
OP
|
$5,816.48
|
|
|
Service Code
|
CPT 78813
|
| Hospital Charge Code |
40400011
|
|
Hospital Revenue Code
|
404
|
| Min. Negotiated Rate |
$1,025.45 |
| Max. Negotiated Rate |
$5,234.83 |
| Rate for Payer: Aetna Commercial |
$4,944.01
|
| Rate for Payer: Aetna Medicare |
$1,512.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,817.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,817.65
|
| Rate for Payer: BCBS Complete |
$1,076.63
|
| Rate for Payer: BCBS MAPPO |
$1,454.12
|
| Rate for Payer: BCBS Trust/PPO |
$4,781.73
|
| Rate for Payer: BCN Commercial |
$4,781.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,454.12
|
| Rate for Payer: Cash Price |
$4,653.18
|
| Rate for Payer: Cofinity Commercial |
$5,002.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,653.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,454.12
|
| Rate for Payer: Healthscope Commercial |
$5,234.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,362.36
|
| Rate for Payer: Mclaren Medicaid |
$1,025.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,526.83
|
| Rate for Payer: Meridian Medicaid |
$1,076.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,672.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,599.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,944.01
|
| Rate for Payer: Nomi Health Commercial |
$4,769.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,362.36
|
| Rate for Payer: PACE Senior Care Partners |
$1,381.41
|
| Rate for Payer: PACE SWMI |
$1,454.12
|
| Rate for Payer: PHP Commercial |
$4,944.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,454.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,025.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,060.34
|
| Rate for Payer: Priority Health Medicare |
$1,468.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,048.27
|
| Rate for Payer: Railroad Medicare Medicare |
$1,454.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,118.50
|
| Rate for Payer: UHC Core |
$4,856.76
|
| Rate for Payer: UHC Exchange |
$1,454.12
|
| Rate for Payer: UHC Medicaid |
$1,025.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,454.12
|
| Rate for Payer: UHCCP Medicaid |
$1,025.45
|
| Rate for Payer: VA VA |
$1,454.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,362.36
|
|
|
HC PET WHOLE BODY
|
Facility
|
IP
|
$5,816.48
|
|
|
Service Code
|
CPT 78813
|
| Hospital Charge Code |
40400011
|
|
Hospital Revenue Code
|
404
|
| Min. Negotiated Rate |
$4,048.27 |
| Max. Negotiated Rate |
$5,234.83 |
| Rate for Payer: Aetna Commercial |
$4,944.01
|
| Rate for Payer: BCBS Trust/PPO |
$4,803.83
|
| Rate for Payer: BCN Commercial |
$4,803.83
|
| Rate for Payer: Cash Price |
$4,653.18
|
| Rate for Payer: Cofinity Commercial |
$5,002.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,653.18
|
| Rate for Payer: Healthscope Commercial |
$5,234.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,362.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,944.01
|
| Rate for Payer: Nomi Health Commercial |
$4,769.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,362.36
|
| Rate for Payer: PHP Commercial |
$4,944.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,060.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,048.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,118.50
|
| Rate for Payer: UHC Core |
$4,856.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,362.36
|
|
|
HC PET WMC CT WHOLE BODY
|
Facility
|
OP
|
$7,381.64
|
|
|
Service Code
|
CPT 78816
|
| Hospital Charge Code |
40400008
|
|
Hospital Revenue Code
|
404
|
| Min. Negotiated Rate |
$1,301.38 |
| Max. Negotiated Rate |
$6,643.48 |
| Rate for Payer: Aetna Commercial |
$6,274.39
|
| Rate for Payer: Aetna Medicare |
$1,919.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,306.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,306.76
|
| Rate for Payer: BCBS Complete |
$1,366.34
|
| Rate for Payer: BCBS MAPPO |
$1,845.41
|
| Rate for Payer: BCBS Trust/PPO |
$6,068.45
|
| Rate for Payer: BCN Commercial |
$6,068.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,845.41
|
| Rate for Payer: Cash Price |
$5,905.31
|
| Rate for Payer: Cofinity Commercial |
$6,348.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,905.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,845.41
|
| Rate for Payer: Healthscope Commercial |
$6,643.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,536.23
|
| Rate for Payer: Mclaren Medicaid |
$1,301.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,937.68
|
| Rate for Payer: Meridian Medicaid |
$1,366.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,122.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,029.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,274.39
|
| Rate for Payer: Nomi Health Commercial |
$6,052.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,536.23
|
| Rate for Payer: PACE Senior Care Partners |
$1,753.14
|
| Rate for Payer: PACE SWMI |
$1,845.41
|
| Rate for Payer: PHP Commercial |
$6,274.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,845.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,301.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,422.03
|
| Rate for Payer: Priority Health Medicare |
$1,863.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,137.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,845.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,495.84
|
| Rate for Payer: UHC Core |
$6,163.67
|
| Rate for Payer: UHC Exchange |
$1,845.41
|
| Rate for Payer: UHC Medicaid |
$1,301.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,845.41
|
| Rate for Payer: UHCCP Medicaid |
$1,301.38
|
| Rate for Payer: VA VA |
$1,845.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,536.23
|
|
|
HC PET WMC CT WHOLE BODY
|
Facility
|
IP
|
$7,381.64
|
|
|
Service Code
|
CPT 78816
|
| Hospital Charge Code |
40400008
|
|
Hospital Revenue Code
|
404
|
| Min. Negotiated Rate |
$5,137.62 |
| Max. Negotiated Rate |
$6,643.48 |
| Rate for Payer: Aetna Commercial |
$6,274.39
|
| Rate for Payer: BCBS Trust/PPO |
$6,096.50
|
| Rate for Payer: BCN Commercial |
$6,096.50
|
| Rate for Payer: Cash Price |
$5,905.31
|
| Rate for Payer: Cofinity Commercial |
$6,348.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,905.31
|
| Rate for Payer: Healthscope Commercial |
$6,643.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,536.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,274.39
|
| Rate for Payer: Nomi Health Commercial |
$6,052.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,536.23
|
| Rate for Payer: PHP Commercial |
$6,274.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,422.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,137.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,495.84
|
| Rate for Payer: UHC Core |
$6,163.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,536.23
|
|
|
HC PFO
|
Facility
|
OP
|
$29,599.06
|
|
|
Service Code
|
CPT 93580
|
| Hospital Charge Code |
48100111
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,218.31 |
| Max. Negotiated Rate |
$26,639.15 |
| Rate for Payer: Aetna Commercial |
$25,159.20
|
| Rate for Payer: Aetna Medicare |
$7,695.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,249.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,249.71
|
| Rate for Payer: BCBS Complete |
$5,478.79
|
| Rate for Payer: BCBS MAPPO |
$7,399.77
|
| Rate for Payer: BCBS Trust/PPO |
$24,333.39
|
| Rate for Payer: BCN Commercial |
$24,333.39
|
| Rate for Payer: BCN Medicare Advantage |
$7,399.77
|
| Rate for Payer: Cash Price |
$23,679.25
|
| Rate for Payer: Cofinity Commercial |
$25,455.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,679.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,399.77
|
| Rate for Payer: Healthscope Commercial |
$26,639.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,199.29
|
| Rate for Payer: Mclaren Medicaid |
$5,218.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,769.75
|
| Rate for Payer: Meridian Medicaid |
$5,478.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,509.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,139.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,159.20
|
| Rate for Payer: Nomi Health Commercial |
$24,271.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,199.29
|
| Rate for Payer: PACE Senior Care Partners |
$7,029.78
|
| Rate for Payer: PACE SWMI |
$7,399.77
|
| Rate for Payer: PHP Commercial |
$25,159.20
|
| Rate for Payer: PHP Medicare Advantage |
$7,399.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,218.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25,751.18
|
| Rate for Payer: Priority Health Medicare |
$7,473.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20,600.95
|
| Rate for Payer: Railroad Medicare Medicare |
$7,399.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,047.17
|
| Rate for Payer: UHC Core |
$24,715.22
|
| Rate for Payer: UHC Exchange |
$7,399.77
|
| Rate for Payer: UHC Medicaid |
$5,218.31
|
| Rate for Payer: UHC Medicare Advantage |
$7,399.77
|
| Rate for Payer: UHCCP Medicaid |
$5,218.31
|
| Rate for Payer: VA VA |
$7,399.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,199.29
|
|
|
HC PFO
|
Facility
|
IP
|
$29,599.06
|
|
|
Service Code
|
CPT 93580
|
| Hospital Charge Code |
48100111
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$20,600.95 |
| Max. Negotiated Rate |
$26,639.15 |
| Rate for Payer: Aetna Commercial |
$25,159.20
|
| Rate for Payer: BCBS Trust/PPO |
$24,445.86
|
| Rate for Payer: BCN Commercial |
$24,445.86
|
| Rate for Payer: Cash Price |
$23,679.25
|
| Rate for Payer: Cofinity Commercial |
$25,455.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,679.25
|
| Rate for Payer: Healthscope Commercial |
$26,639.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,199.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,159.20
|
| Rate for Payer: Nomi Health Commercial |
$24,271.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,199.29
|
| Rate for Payer: PHP Commercial |
$25,159.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25,751.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20,600.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,047.17
|
| Rate for Payer: UHC Core |
$24,715.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,199.29
|
|
|
HC PFO OCCLUDER
|
Facility
|
IP
|
$11,699.82
|
|
|
Service Code
|
HCPCS C1817
|
| Hospital Charge Code |
27800116
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,143.07 |
| Max. Negotiated Rate |
$10,529.84 |
| Rate for Payer: Aetna Commercial |
$9,944.85
|
| Rate for Payer: BCBS Trust/PPO |
$9,662.88
|
| Rate for Payer: BCN Commercial |
$9,662.88
|
| Rate for Payer: Cash Price |
$9,359.86
|
| Rate for Payer: Cofinity Commercial |
$10,061.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,359.86
|
| Rate for Payer: Healthscope Commercial |
$10,529.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,774.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,944.85
|
| Rate for Payer: Nomi Health Commercial |
$9,593.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,774.86
|
| Rate for Payer: PHP Commercial |
$9,944.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,178.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,143.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,295.84
|
| Rate for Payer: UHC Core |
$9,769.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,774.86
|
|
|
HC PFO OCCLUDER
|
Facility
|
OP
|
$11,699.82
|
|
|
Service Code
|
HCPCS C1817
|
| Hospital Charge Code |
27800116
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,062.68 |
| Max. Negotiated Rate |
$10,529.84 |
| Rate for Payer: Aetna Commercial |
$9,944.85
|
| Rate for Payer: Aetna Medicare |
$3,041.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,656.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,656.19
|
| Rate for Payer: BCBS Complete |
$2,165.64
|
| Rate for Payer: BCBS MAPPO |
$2,924.95
|
| Rate for Payer: BCBS Trust/PPO |
$9,618.42
|
| Rate for Payer: BCN Commercial |
$9,618.42
|
| Rate for Payer: BCN Medicare Advantage |
$2,924.95
|
| Rate for Payer: Cash Price |
$9,359.86
|
| Rate for Payer: Cofinity Commercial |
$10,061.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,359.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,924.95
|
| Rate for Payer: Healthscope Commercial |
$10,529.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,774.86
|
| Rate for Payer: Mclaren Medicaid |
$2,062.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,071.20
|
| Rate for Payer: Meridian Medicaid |
$2,165.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,363.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,217.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,944.85
|
| Rate for Payer: Nomi Health Commercial |
$9,593.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,774.86
|
| Rate for Payer: PACE Senior Care Partners |
$2,778.71
|
| Rate for Payer: PACE SWMI |
$2,924.95
|
| Rate for Payer: PHP Commercial |
$9,944.85
|
| Rate for Payer: PHP Medicare Advantage |
$2,924.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,062.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,178.84
|
| Rate for Payer: Priority Health Medicare |
$2,954.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,143.07
|
| Rate for Payer: Railroad Medicare Medicare |
$2,924.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,295.84
|
| Rate for Payer: UHC Core |
$9,769.35
|
| Rate for Payer: UHC Exchange |
$2,924.95
|
| Rate for Payer: UHC Medicaid |
$2,062.68
|
| Rate for Payer: UHC Medicare Advantage |
$2,924.95
|
| Rate for Payer: UHCCP Medicaid |
$2,062.68
|
| Rate for Payer: VA VA |
$2,924.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,774.86
|
|
|
HC PHARMA AGENT CHALLENGE
|
Facility
|
IP
|
$3,956.14
|
|
|
Service Code
|
CPT 93463
|
| Hospital Charge Code |
48100022
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,753.47 |
| Max. Negotiated Rate |
$3,560.53 |
| Rate for Payer: Aetna Commercial |
$3,362.72
|
| Rate for Payer: BCBS Trust/PPO |
$3,267.38
|
| Rate for Payer: BCN Commercial |
$3,267.38
|
| Rate for Payer: Cash Price |
$3,164.91
|
| Rate for Payer: Cofinity Commercial |
$3,402.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,164.91
|
| Rate for Payer: Healthscope Commercial |
$3,560.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,967.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,362.72
|
| Rate for Payer: Nomi Health Commercial |
$3,244.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,967.11
|
| Rate for Payer: PHP Commercial |
$3,362.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,441.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,753.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,481.40
|
| Rate for Payer: UHC Core |
$3,303.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,967.11
|
|
|
HC PHARMA AGENT CHALLENGE
|
Facility
|
OP
|
$3,956.14
|
|
|
Service Code
|
CPT 93463
|
| Hospital Charge Code |
48100022
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$697.47 |
| Max. Negotiated Rate |
$3,560.53 |
| Rate for Payer: Aetna Commercial |
$3,362.72
|
| Rate for Payer: Aetna Medicare |
$1,028.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,236.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,236.29
|
| Rate for Payer: BCBS Complete |
$732.28
|
| Rate for Payer: BCBS MAPPO |
$989.03
|
| Rate for Payer: BCBS Trust/PPO |
$3,252.34
|
| Rate for Payer: BCN Commercial |
$3,252.34
|
| Rate for Payer: BCN Medicare Advantage |
$989.03
|
| Rate for Payer: Cash Price |
$3,164.91
|
| Rate for Payer: Cofinity Commercial |
$3,402.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,164.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$989.03
|
| Rate for Payer: Healthscope Commercial |
$3,560.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,967.11
|
| Rate for Payer: Mclaren Medicaid |
$697.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,038.49
|
| Rate for Payer: Meridian Medicaid |
$732.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,137.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,087.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,362.72
|
| Rate for Payer: Nomi Health Commercial |
$3,244.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,967.11
|
| Rate for Payer: PACE Senior Care Partners |
$939.58
|
| Rate for Payer: PACE SWMI |
$989.03
|
| Rate for Payer: PHP Commercial |
$3,362.72
|
| Rate for Payer: PHP Medicare Advantage |
$989.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$697.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,441.84
|
| Rate for Payer: Priority Health Medicare |
$998.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,753.47
|
| Rate for Payer: Railroad Medicare Medicare |
$989.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,481.40
|
| Rate for Payer: UHC Core |
$3,303.38
|
| Rate for Payer: UHC Exchange |
$989.03
|
| Rate for Payer: UHC Medicaid |
$697.47
|
| Rate for Payer: UHC Medicare Advantage |
$989.03
|
| Rate for Payer: UHCCP Medicaid |
$697.47
|
| Rate for Payer: VA VA |
$989.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,967.11
|
|
|
HC PHARYNX AND OR CERVICAL ESOPHAGUS
|
Facility
|
OP
|
$282.36
|
|
|
Service Code
|
CPT 74210
|
| Hospital Charge Code |
32000295
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$49.78 |
| Max. Negotiated Rate |
$254.12 |
| Rate for Payer: Aetna Commercial |
$240.01
|
| Rate for Payer: Aetna Medicare |
$73.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$88.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$88.24
|
| Rate for Payer: BCBS Complete |
$52.26
|
| Rate for Payer: BCBS MAPPO |
$70.59
|
| Rate for Payer: BCBS Trust/PPO |
$232.13
|
| Rate for Payer: BCN Commercial |
$232.13
|
| Rate for Payer: BCN Medicare Advantage |
$70.59
|
| Rate for Payer: Cash Price |
$225.89
|
| Rate for Payer: Cofinity Commercial |
$242.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.59
|
| Rate for Payer: Healthscope Commercial |
$254.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$211.77
|
| Rate for Payer: Mclaren Medicaid |
$49.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.12
|
| Rate for Payer: Meridian Medicaid |
$52.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$77.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.01
|
| Rate for Payer: Nomi Health Commercial |
$231.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$211.77
|
| Rate for Payer: PACE Senior Care Partners |
$67.06
|
| Rate for Payer: PACE SWMI |
$70.59
|
| Rate for Payer: PHP Commercial |
$240.01
|
| Rate for Payer: PHP Medicare Advantage |
$70.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$245.65
|
| Rate for Payer: Priority Health Medicare |
$71.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$196.52
|
| Rate for Payer: Railroad Medicare Medicare |
$70.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$248.48
|
| Rate for Payer: UHC Core |
$235.77
|
| Rate for Payer: UHC Exchange |
$70.59
|
| Rate for Payer: UHC Medicaid |
$49.78
|
| Rate for Payer: UHC Medicare Advantage |
$70.59
|
| Rate for Payer: UHCCP Medicaid |
$49.78
|
| Rate for Payer: VA VA |
$70.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$211.77
|
|
|
HC PHARYNX AND OR CERVICAL ESOPHAGUS
|
Facility
|
IP
|
$282.36
|
|
|
Service Code
|
CPT 74210
|
| Hospital Charge Code |
32000295
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$196.52 |
| Max. Negotiated Rate |
$254.12 |
| Rate for Payer: Aetna Commercial |
$240.01
|
| Rate for Payer: BCBS Trust/PPO |
$233.20
|
| Rate for Payer: BCN Commercial |
$233.20
|
| Rate for Payer: Cash Price |
$225.89
|
| Rate for Payer: Cofinity Commercial |
$242.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.89
|
| Rate for Payer: Healthscope Commercial |
$254.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$211.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.01
|
| Rate for Payer: Nomi Health Commercial |
$231.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$211.77
|
| Rate for Payer: PHP Commercial |
$240.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$245.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$196.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$248.48
|
| Rate for Payer: UHC Core |
$235.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$211.77
|
|
|
HC PHASE III REHAB FULL MONTH
|
Facility
|
OP
|
$50.00
|
|
| Hospital Charge Code |
99000048
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$8.81 |
| Max. Negotiated Rate |
$45.00 |
| Rate for Payer: Aetna Commercial |
$42.50
|
| Rate for Payer: Aetna Medicare |
$13.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.62
|
| Rate for Payer: BCBS Complete |
$9.26
|
| Rate for Payer: BCBS MAPPO |
$12.50
|
| Rate for Payer: BCBS Trust/PPO |
$41.10
|
| Rate for Payer: BCN Commercial |
$41.10
|
| Rate for Payer: BCN Medicare Advantage |
$12.50
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$43.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.50
|
| Rate for Payer: Healthscope Commercial |
$45.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.50
|
| Rate for Payer: Mclaren Medicaid |
$8.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.12
|
| Rate for Payer: Meridian Medicaid |
$9.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.50
|
| Rate for Payer: Nomi Health Commercial |
$41.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.50
|
| Rate for Payer: PACE Senior Care Partners |
$11.88
|
| Rate for Payer: PACE SWMI |
$12.50
|
| Rate for Payer: PHP Commercial |
$42.50
|
| Rate for Payer: PHP Medicare Advantage |
$12.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.50
|
| Rate for Payer: Priority Health Medicare |
$12.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.80
|
| Rate for Payer: Railroad Medicare Medicare |
$12.50
|
| Rate for Payer: UHC Core |
$41.75
|
| Rate for Payer: UHC Exchange |
$12.50
|
| Rate for Payer: UHC Medicaid |
$8.81
|
| Rate for Payer: UHC Medicare Advantage |
$12.50
|
| Rate for Payer: UHCCP Medicaid |
$8.81
|
| Rate for Payer: VA VA |
$12.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.50
|
|
|
HC PHASE III REHAB FULL MONTH
|
Facility
|
IP
|
$50.00
|
|
| Hospital Charge Code |
99000048
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$34.80 |
| Max. Negotiated Rate |
$45.00 |
| Rate for Payer: Aetna Commercial |
$42.50
|
| Rate for Payer: BCBS Trust/PPO |
$41.30
|
| Rate for Payer: BCN Commercial |
$41.30
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$43.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.00
|
| Rate for Payer: Healthscope Commercial |
$45.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.50
|
| Rate for Payer: Nomi Health Commercial |
$41.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.50
|
| Rate for Payer: PHP Commercial |
$42.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.80
|
| Rate for Payer: UHC Core |
$41.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.50
|
|
|
HC PHASE III REHAB PARTIAL MONTH
|
Facility
|
IP
|
$25.00
|
|
| Hospital Charge Code |
99000049
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$17.40 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Aetna Commercial |
$21.25
|
| Rate for Payer: BCBS Trust/PPO |
$20.65
|
| Rate for Payer: BCN Commercial |
$20.65
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$21.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.00
|
| Rate for Payer: Healthscope Commercial |
$22.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.25
|
| Rate for Payer: Nomi Health Commercial |
$20.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.75
|
| Rate for Payer: PHP Commercial |
$21.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.40
|
| Rate for Payer: UHC Core |
$20.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.75
|
|
|
HC PHASE III REHAB PARTIAL MONTH
|
Facility
|
OP
|
$25.00
|
|
| Hospital Charge Code |
99000049
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$4.41 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Aetna Commercial |
$21.25
|
| Rate for Payer: Aetna Medicare |
$6.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.81
|
| Rate for Payer: BCBS Complete |
$4.63
|
| Rate for Payer: BCBS MAPPO |
$6.25
|
| Rate for Payer: BCBS Trust/PPO |
$20.55
|
| Rate for Payer: BCN Commercial |
$20.55
|
| Rate for Payer: BCN Medicare Advantage |
$6.25
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$21.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.25
|
| Rate for Payer: Healthscope Commercial |
$22.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.75
|
| Rate for Payer: Mclaren Medicaid |
$4.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.56
|
| Rate for Payer: Meridian Medicaid |
$4.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.25
|
| Rate for Payer: Nomi Health Commercial |
$20.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.75
|
| Rate for Payer: PACE Senior Care Partners |
$5.94
|
| Rate for Payer: PACE SWMI |
$6.25
|
| Rate for Payer: PHP Commercial |
$21.25
|
| Rate for Payer: PHP Medicare Advantage |
$6.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.75
|
| Rate for Payer: Priority Health Medicare |
$6.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.40
|
| Rate for Payer: Railroad Medicare Medicare |
$6.25
|
| Rate for Payer: UHC Core |
$20.88
|
| Rate for Payer: UHC Exchange |
$6.25
|
| Rate for Payer: UHC Medicaid |
$4.41
|
| Rate for Payer: UHC Medicare Advantage |
$6.25
|
| Rate for Payer: UHCCP Medicaid |
$4.41
|
| Rate for Payer: VA VA |
$6.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.75
|
|
|
HC PH BLOOD
|
Facility
|
IP
|
$70.75
|
|
|
Service Code
|
CPT 82800
|
| Hospital Charge Code |
30100215
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.24 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: BCBS Trust/PPO |
$58.43
|
| Rate for Payer: BCN Commercial |
$58.43
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.06
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$61.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.26
|
| Rate for Payer: UHC Core |
$59.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
|
|
HC PH BLOOD
|
Facility
|
OP
|
$70.75
|
|
|
Service Code
|
CPT 82800
|
| Hospital Charge Code |
30100215
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.47 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: Aetna Medicare |
$18.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.11
|
| Rate for Payer: BCBS Complete |
$13.10
|
| Rate for Payer: BCBS MAPPO |
$17.69
|
| Rate for Payer: BCBS Trust/PPO |
$58.16
|
| Rate for Payer: BCN Commercial |
$58.16
|
| Rate for Payer: BCN Medicare Advantage |
$17.69
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.69
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: Mclaren Medicaid |
$12.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.57
|
| Rate for Payer: Meridian Medicaid |
$13.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.06
|
| Rate for Payer: PACE Senior Care Partners |
$16.80
|
| Rate for Payer: PACE SWMI |
$17.69
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: PHP Medicare Advantage |
$17.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$61.55
|
| Rate for Payer: Priority Health Medicare |
$17.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.24
|
| Rate for Payer: Railroad Medicare Medicare |
$17.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.26
|
| Rate for Payer: UHC Core |
$59.08
|
| Rate for Payer: UHC Exchange |
$17.69
|
| Rate for Payer: UHC Medicaid |
$12.47
|
| Rate for Payer: UHC Medicare Advantage |
$17.69
|
| Rate for Payer: UHCCP Medicaid |
$12.47
|
| Rate for Payer: VA VA |
$17.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
|
|
HC PH BODY FLUID
|
Facility
|
OP
|
$25.67
|
|
|
Service Code
|
CPT 83986
|
| Hospital Charge Code |
30100384
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$23.10 |
| Rate for Payer: Aetna Commercial |
$21.82
|
| Rate for Payer: Aetna Medicare |
$6.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.02
|
| Rate for Payer: BCBS Complete |
$4.75
|
| Rate for Payer: BCBS MAPPO |
$6.42
|
| Rate for Payer: BCBS Trust/PPO |
$21.10
|
| Rate for Payer: BCN Commercial |
$21.10
|
| Rate for Payer: BCN Medicare Advantage |
$6.42
|
| Rate for Payer: Cash Price |
$20.54
|
| Rate for Payer: Cofinity Commercial |
$22.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.42
|
| Rate for Payer: Healthscope Commercial |
$23.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.25
|
| Rate for Payer: Mclaren Medicaid |
$4.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.74
|
| Rate for Payer: Meridian Medicaid |
$4.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.82
|
| Rate for Payer: Nomi Health Commercial |
$21.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.25
|
| Rate for Payer: PACE Senior Care Partners |
$6.10
|
| Rate for Payer: PACE SWMI |
$6.42
|
| Rate for Payer: PHP Commercial |
$21.82
|
| Rate for Payer: PHP Medicare Advantage |
$6.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.33
|
| Rate for Payer: Priority Health Medicare |
$6.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.87
|
| Rate for Payer: Railroad Medicare Medicare |
$6.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.59
|
| Rate for Payer: UHC Core |
$21.43
|
| Rate for Payer: UHC Exchange |
$6.42
|
| Rate for Payer: UHC Medicaid |
$4.53
|
| Rate for Payer: UHC Medicare Advantage |
$6.42
|
| Rate for Payer: UHCCP Medicaid |
$4.53
|
| Rate for Payer: VA VA |
$6.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.25
|
|
